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Several schools or portions of schools were temporarily closed by the Medical Officer of
the Education Department of the London County Council for measles, during which time they
were disinfected viz.: Fair Street, Infant's Classroom "A"; Midway Place, Classroom "G"
Magdalen Street, St. Paul's, Pages Walk, Grange Walk, Infants; Farncombe Street, Infants;
Southwark Park, Classroom "A," Infants; and Rotherhithe New Road, Classroom "VII.,
Infants.
The total cost of disinfecting measles during the year was £247 8s. 7d., the cost of disinfecting
other infectious diseases being £270 18s. 11d.
In addition to the precaution of disinfection, the following leaflet is sent per post to each
house where a case of measles is known to occur along with the copy of the section of the
Public Health Act dealing with infectious diseases.
METROPOLITAN BOROUGH OF BERMONDSEY.
PRECAUTIONS IN MEASLES.
The Council of the Metropolitan Borough of Bermondsey desire to draw the attention of parents and
guardians to the serious nature of measles. During 1903 it caused more deaths than any other infectious
disease. In the first six months of 1904 it caused 90 deaths, 86 of which were in children under five
years of age. It is therefore MOST FATAL IN YOUNG CHILDREN.
Death in measles is nearly always caused by complications, and those which occur most frequently
are PNEUMONIA and BRONCHITIS. It is therefore MOST IMPORTANT that on the first symptoms
the patient should be isolated and KEPT IN BED, IN A WARM, WELL-VENTILATED ROOM, so
as not to "catch cold." As the eyes are very sensitive to light it is advisable that the patient should be
so placed that it should not shine directly into them.
It takes ten or eleven days after the child has become infected before the first symptoms appear.
These come on somewhat SUDDENLY, and consist of sneezing, coughing, running and redness of
the eyes and nose, loss of appetite, the symptoms generally being those of a bad cold.
On the fourth day the rash appears, usually first about the roots of the hair, forehead, sides of the
head, and neck, and rapidly invades the remainder of the trunk and limbs. .
MEDICAL ADVICE should ALWAYS be sought at this stage and STRICTLY FOLLOWED.
The patient, if attending school, should be excluded on the first suspicious symptoms, and as soon as they
are confirmed by the beginning of the rash, the other members of the family attending school should
also be excluded. Complications are most liable to appear during the height of the rash, but a patient is
NEVER SAFE from them until recovery is complete.
This generally takes three or four weeks. In order to prevent the patient and members of the
family carrying infection back to school it is MOST IMPORTANT that their clothes should be
DISINFECTED before return there. This will be done on receipt of enclosed post card duly filled up.
R. K. BROWN, M.D.,
Medical Officer of Health.
Town Hall.
The results of all these precautions have been somewhat disappointing, considering that it
is the first year during which disinfection has been systematically carried out; for in this year
we have the highest mortality from measles of any year during the past eleven years with the
one exception of 1902. The question whether it is worth spending this amount on disinfection
considering the small return is at present under consideration.
Chicken-pox.
This disease was made notifiable by an Order of the London County Council from April
7th till November 7th, 1904. There were 294 notifications during this period. None of these
turned out subsequently to be small-pox. As mentioned in the section of this report dealing
with small-pox, some cases in Hatteraick Street were treated as chicken-pox and turned out to be
small-pox, but the former was not notifiable at this period.
Membranous Croup.
There were no notifications from this disease, against 2 in 1903.
Notification of Phthisis.
128 cases of phthisis were voluntarily notified in 1905. The leaflet with precautions was
posted at once to the patient, and this was followed in the course of a week or two by a visit
from myself. I then amplified the recommendations and pointed out the value of disinfection,
which was accepted in some cases. Prom these visits, besides the benefit of the advice to the
patients, I learned that the knowledge of the infectious nature of consumption is becoming much
more common, and that the people are more anxious to do everything in their power not to be
a danger to others. Those patients who have been to sanatoria, convalescent homes and
hospitals for this disease, are much the most careful, and sanatoria for the poor, if they did
nothing else than train people in the hygiene of phthisis, would be doing an excellent work. I
hope to see phthisis compulsorily notifiable before very long, and the principal work which the
voluntary notification is doing at present is preparing public opinion for this extension, The
fear in the public mind is that if phthisis is classed with the other infectious diseases there will
be too much interference with the liberty of the patient, especially in relation to his occupation.
It should, however, be made clear that this will not be the case, but disinfection at stated
intervals, as advised by the medical attendant, should be insisted on. Every case also should
have a period of treatment at an open-air sanatorium, but until the Metropolitan Asylums
Board take up the provision of these seriously I fear we will remain a long way behind-hand
in London.
Disinfection was carried out in 77 cases, but this was mostly after death from this
disease.
The annexed table gives the ages and occupation of all the cases notified up to
December 31st, 1904.
Of the 128 cases notified in 1904, in 40 there was a family history of phthisis in near
relatives, in 20 there was a similar history in distant relatives, in 4 the patients' husbands were
phthisical, in 14 no information was obtainable, and in 70 the family history as regards phthisis
seemed to be good.
I certainly see no reason to give up the voluntary notification, but on the contrary hope
it will be extended at no distant date.